title: A randomized controlled pilot trial comparing the impact of access to clinical endocrinology video demonstrations with access to usual revision resources on medical student performance of clinical endocrinology skills.
abstract: BACKGROUND
  Demonstrating competence in clinical skills is key to course completion for medical students. Methods of providing clinical instruction that foster immediate learning and potentially serve as longer-term repositories for on-demand revision, such as online videos demonstrating competent performance of clinical skills, are increasingly being used. However, their impact on learning has been little studied. The aim of this study was to determine the value of adjunctive on-demand video-based training for clinical skills acquisition by medical students in endocrinology.
  
  
  METHODS
  Following an endocrinology clinical tutorial program, 2nd year medical students in the pre-assessment revision period were recruited and randomized to either a set of bespoke on-line clinical skills training videos (TV), or to revision as usual (RAU). The skills demonstrated on video were history taking in diabetes mellitus (DMH), examination for diabetes lower limb complications (LLE), and examination for signs of thyroid disease (TE). Students were assessed on these clinical skills in an observed structured clinical examination two weeks after randomization. Assessors were blinded to student randomization status.
  
  
  RESULTS
  For both diabetes related clinical skills assessment tasks, students in the TV group performed significantly better than those in the RAU group. There were no between group differences in thyroid examination performance. For the LLE, 91.7% (n = 11/12) of students randomized to the video were rated globally as competent at the skill compared with 40% (n = 4/10) of students not randomized to the video (p = 0.024). For the DMH, 83.3% (n = 10/12) of students randomized to the video were rated globally as competent at the skill compared with 20% (n = 2/10) of students not randomized to the video (p = 0.007).
  
  
  CONCLUSIONS
  Exposure to high quality videos demonstrating clinical skills can significantly improve medical student skill performance in an observed structured clinical examination of these skills, when used as an adjunct to clinical skills face-to-face tutorials and deliberate practice of skills in a blended learning format. Video demonstrations can provide an enduring, on-demand, portable resource for revision, which can even be used at the bedside by learners. Such resources are cost-effectively scalable for large numbers of learners.
authors.affiliation: Sydney Medical School Nepean, University of Sydney, PO Box 63, Penrith, NSW 2751, Australia. emily.hibbert@sydney.edu.au.
authors.forename: Emily J
authors.initials: EJ
authors.lastname: Hibbert
authors.forename: Tim
authors.initials: T
authors.lastname: Lambert
authors.forename: John N
authors.initials: JN
authors.lastname: Carter
authors.forename: Diana L
authors.initials: DL
authors.lastname: Learoyd
authors.forename: Stephen
authors.initials: S
authors.lastname: Twigg
authors.forename: Stephen
authors.initials: S
authors.lastname: Clarke
mesh_terms: D002983:Clinical Competence / Q000592:standards; D048909:Diabetes Complications / Q000175:diagnosis / Q000628:therapy; D003920:Diabetes Mellitus / Q000175:diagnosis / Q000628:therapy; D004521:Educational Measurement; D004704:Endocrinology / Q000193:education* / Q000592:standards; D006801:Humans; D008487:Medical History Taking; D010808:Physical Examination; D016037:Single-Blind Method; D013337:Students, Medical; D014741:Video Recording / Q000379:methods